The URL can be used to link to this page

11020111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7533 BOLLINGER RD CONTRACTOR:SERVICE CHAMPIONS PERMIT NO: 11020111 OWNER'S NAME: KAREN A LEASURE 7020 COMMERCE DR DATE ISSUED:02/28/2011 011""vER'S PHONE: 4085644959 PLEASANTON,CA 94588 PHONE NO:(925)444-4444 G LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT F_ PLUMB r License Class 2 Lic.# 91 7L MECH RESIDENTIAL COMMERCIAL r Contractor Date Z�� I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE FURNACE ONLY IN CLOSET (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4745 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. U) APN Number:35923031.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply ri with all non-point source regulations per the Cupertino Municipal Code,Section Issued by• ��—�" —rte�� Date: 9.18. p� G Signature-/ AOPDate ��O RE-ROOFS: [ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Owe ath rized Compensation laws of California. If,after making this certificate of exemption,I Date: become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION C and expenses which may accrue against said City in consequence of the L rg of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. wan all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 7533 bollinger rd. DATE: 02/28/2011 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$4,745 xPERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or DuplexPENTAMATION FURN/AC USE: PERMIT TYPE: A wORK re lace existing furnace at closet location SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $126 TOTALS: $126.00 Mech.Plan Check0.0 hrs $0.00 < Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs L1 Li NOTE. Theseees are based on the preliminary information available and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS {Fee Resohition 09-051 E(L 711'1,-70) FEE QTY/FEE MISC ITEMS Man C'hcck Fcc,: mull/. P("l ec F-1 PME Plan Check: $0.00 sl!/)1)/. dt.>1) 1-1't' PME Unit Fee: $126.00 PME Permit Fee: $42.00 Co7d.Swiwiion 1 CLV "I"olislicell 1ic=5 icy l Work Without Permit? 0 Yes 0 No $0.00 I'lctr7nb % Travel Documentation Fee: 1 TRA VDOC $42.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $211.50 $0.00 TOTAL FEE: $211.50 Revised: 01/15/2011 CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35923031. 00 DATE ISSUED. . . . . . . : 02/28/2011 RECEIPT #. . . . . . . . . BS000012785 REFERENCE ID # . . . : 11020111 SITE ADDRESS . . . . . : 7533 BOLLINGER RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER KAREN A LEASURE ADDRESS 7533 BOLLINGER CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4332 RECEIVED FROM . . . . : IE INC CONTRACTOR KEVIN COMERFORD LIC # 31833 COMPANY SERVICE CHAMPIONS ADDRESS 7020 COMMERCE DR CITY/STATE/ZIP . . . : PLEASANTON, CA 94588 TELEPHONE . . . . . . . . : (925) 444-4444 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---- 1BCBSC VALUATION 4, 745 .00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 4, 745 . 00 0. 50 0 . 00 0 .50 0 . 00 1MFR=<100 UNITS 1 .00 126 . 00 0 .00 126 . 00 0 . 00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0. 00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0 .00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 211 .50 0 .00 211 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 211 . 50 47502 --------------- TOTAL RECEIPT 211 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Sim lified Press ' live Certificate of Co fiance:20M Residential HT'ACAheratiow CF-1 R-ALT-HVAC C,fmat1e 1zoaea 10 to 15 Site Ael&em Eqb meanest A,gesc.7. Dad-: Permit i! 3 �2-a Conditioned Floor Equipment Type' List ll mimum Effcci Duct insulation requirement Area Thermostat O Packaged UnitOver 40 ft of ducts added or to Furnace AFUE QS ❑COP 18 s�aCk O Indoor Coll 13SEER ❑HSPF —placed in mrcaodiaoned space Served by systrm (ff��, O Condensing Unit 13 EER O Resistance OR 6 (CZ J0-13) rf pr+esent meat be Ia Other O R 8 (CZ 14-15) rnrtattadl 1_Eq qp—%1 Type_Choose the eguornew being instaUed'if retort drat one sp hem use another CF-1 R-A.LT-HYACfor each systemm 2.Mhrirrwm Equipment Efficknciear 13 SEER,78%AFUF.,7.7HSPFfor typical residential system. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and pricks one of the appropriate Options. Each Option fiats the HERS measures that must be conducted.A copy of the faros shall be left on site for final inspection and a copy given to the homeowner_ At Snap,the inspector verifies that the work listed on this foam was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-41Z forms(no hand filled CF4Rs allowed)are filled out and signed, Beginning October 1,2010,a r copy of the CF-I R and CF-R shall also be an We for final haspecdon. ®1.HVAC Changeout Forms: CF-611 fan= MECT14W,MECH-2I-HERS and(for split systems)MECH-25-HERS • All HVAC Equipment replaced CF4R fumes: MECH-2I and for split MECH-25 • Condenser Cal and/or CF-6R fixins: MECH-2I-HMLS andfar lit • Indoor Coil and/or ( split )MECH-25-HERS CF4R fotms. MECH-21 and(for split systems) MECH-25 • Furnace For.Spfit Systems:Duct leakage<15 percent; RC,CCA>_300 CFMAan(Minimtun Air Flow Regaiiranent),TMAH For Packaged Units: Duct leakage<15 pement Exempted from duct leakage testing if r, 0 1.Dadays/em was documented to have been previously sealed and eoanSrmad through HERS verificatiah,or O 2.Duct system with less than 40 lunar feet in tmconditiounod spans,or O 3.Existing duct art construeted,insulated or scaled with asbestos O 2.New HVAC System Required Forms. • Cut in or Changeout with new . CF-6R forms: MECK-O4.MECH 20-HERS,and(for dada:(all new ducting and all t;piit systems)MBCH-22-HERS,and MFeCH-25-HERS CF4R forms: MECH 20-.and(for split systems)UBM-22,sod MECH 25 new . For Split Systems:Dud leakage<6 parent;RC,CCA>_350 CFM/ton,FWD,TMA1f,STNS S,and either HSPP or PVP. For Pac Units:Duct!!!!LAM<6 percent ❑3.New Ducts with Replacement Rapired Forma: a Includes replacing or instalHog all newduding C7-6R ftm MECH-04,hCB01-20-MtS,and(for split systems)NIEC p-25-HERS and/or outdoor condensing unit and/or indoor CIZAR farmer NECH-20 and(for split systems)M OM25 coil and/or furnace. Not all equipment edea ngod. For Spfit Systems:Dud leakage<6 percent,RC,CCA>300 CFM/ton,TMAH For Packaged Units:Dud 1 e<6 percent O 4.New DuctiM over 40 feet Reavired Forms: • Includes adding or replacing more @tan 40 CF-6R fonts MECH-04,MECH-21 HERS CF-4R farms: MECH-21 linear fed of duet in unconditioned For sppit system or packaged mita: Duct leakage<15 percent Q EXCEPTION:E=ftW dud systems constructed,insalaied or sealed with asbestos. Contractor(Documentation Aathoei/RespetuiiW Designer's Declaration Statement)' .• I ratify that this Certificate erPComplie►ryee d:.rur�Ltiean is aexmate sod - . _• .i am cE&lc unde,Divi#gn 3o one Colifomia Busiom and Professions Code to accept r espooscildfity for the dedgo idemhW oa this Certificate of Compliance. I ratify that the cocrgy founts aad.perf mnance tions for the desip identified on this Cerdfiesme of Complance eonfarm to the a D*Tc rents of Talc 24, Parts 1 qud 6 cif the Catlforuia•Cooc.of Re pbboos..: • 71u design feat res:idem an alis C rti5cate of Compliance are coast wt with the Wosmetim doeame need ca other applicable covV iance forms,worlwbe cts, roc sad snhenitted b the mforoammt cythromm4wlthelel Nares IMAXINE 13ROOKS —r DOWE VICE CHAMPIONS Address o2 W ("ih d`/`G® /{U Iacerisa 817040 °ii3dStatrlZipx 5A/L JJ 5 f✓i� 5! 3 1 Phnind H DS3 94ti 93.q CL 2008 Residential Con pliarnce Founts March 2010 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 5 3 L1 tri �r d PERMIT# -- OWNER'S NAME: (Arf,JV) SU r 9, PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # _ ADDRESS: -7J1-1 CITY/ZIPCODE: 66cvi. *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: � t L Signature Date Please check applicable subcontractors and complete the following information: &/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum /Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date C!TY OF CITY OF CUPERTINO LQ FURNACE/AC C U P E RT I N O PERMIT APPLICATION FORM Date: Building Address: Owner's Name: Phone#: I�Cc��e Lea su./,g WS,' 6-& Ll - '-7 Contractor: _ Phone#:q0 :�a� q`/G/- y3 Vg Fax#: Contractor License#: Cupertino Business License#: (3 1-707-1C Contact: Phone#: Fax#: Building Permit Info: Elect Plumb Mech [ Residential N1 Commercial Job Description: 12� �QLe For Residential Installations: Attic ❑ 1 St floor 2"�floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction(Usage Class): Strapped On Platform BondedEl New Location Replacement Project Size: Ex ress❑ Standard❑ Lar e❑ N1a'or❑ Valuation: N Q Green Building: Please complete relevant portion of the Green Building Checklist&attach it to the application or if applicable,include in plan set&the sheet index. Revised 01/07/09 CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10122 BRET AVE CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 101001 18 REMODELING OWNER'S NAME: VIVEK KARNATAKI&DEEPTI NAIK 681 E BROKAW RD DATE ISSUED: 12/22/2010 OWNER'S PHONE: 4086674018 SAN JOSE,CA 95112 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG � ELECT� PLUMB� License Class Lic.# MECH f RESIDENTIAL COMMERCIAL Ir Contractor , Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT 2 STORY SFDWL 3,384 W ATTACHED (commencing with Section 7000)of Division 3 of the Business&Professions GARAGE Code and that my license is in full force and effect. 431 SQ FT-SANITARY IS SUNNYVALE'S JURISDICTION 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. /11Z_ Sq.Ft Floor Arca: Valuation:$850000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:3751 1040.00 Occupancy Type: correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. J y - Signature Date Issued by: �- �— Date: ❑ "R-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspectedprior to any roofing material being installed. If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant:_ Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 1 have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air 1 certify that in the performance of the work for which this permit is issued,1 shall contaminants as defined by the Bay Area Air Quality Management District 1 will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner uthorized agent: q =therois Date: APPLICANT CERTIFICATION TION LENDING AGENCY I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating I hereby ction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ARCHITECT'S DECLARATION — I understand my plans shall be used as public records. Signature Date Licensed Professional